Children enrolling in child care facilities, pre-school, pre-Kindergarten Infants entering child care facilities must be up to date at the time of enrollment and are required to provide an updated certificate after completing all of the required vaccines due no later than 18 months of age.

Diphtheria-Tetanus-Pertussis (DTaP, or DT if appropriate)

Poliomyelitis (IPV or OPV)

Measles, Mumps, Rubella (1 dose of each, normally given together as MMR)

Varicella (1 dose or credible history of disease)

Haemophilus influenzae type B (Hib) – age younger than 5 years only (This requirement is resumed immediately, following suspension during a national Hib vaccine shortage 2008-2009)

All children entering 7th grade (including currently enrolled students)

Tetanus-diphtheria-pertussis booster ("Tdap"): evidence of one Tdap dose given any time before 7th grade entry is required regardless of Td history (2013 update)

Verification of immunity to varicella – 2 doses or credible history of disease (July 1, 2010)

Children who are new enrollees in a TN school in grades other than Kindergarten

Diphtheria-Tetanus-Pertussis (DTaP, or DT if appropriate)

Measles, Mumps, Rubella (2 doses of each, normally given together as MMR)

Poliomyelitis (IPV or OPV) – final dose on or after the 4th birthday now required

Varicella (2 doses or credible history of disease) – previously only one dose was required

Hepatitis B (HBV) – previously only for Kindergarten, 7th grade entry

New students entering grades other than 7th grade are not required to have Tdap

Children with medical or religious exemption to requirements

Medical – Physician (MD, DO) or department Public Health Nurse authorized to indicate specific vaccines medically exempted (because of risk of harm) on the new form. Other vaccines remain required. The medical reason for the exemption does not need to be provided.

Religious – This exemption requires a signed statement by the parent/guardian that vaccination conflicts with their religious tenets or practices. If the child needs documentation of a health examination for the school, it must be noted by the healthcare provider on the immunization certificate. In that case, the provider should check the box that the parent has sought a religious exemption to explain why immunization information is absent or incomplete.